Until March 28, 2020, there were ~90,000 confirmed cases of coronavirus disease (COVID-19) in Italy, with 26,000 in-patients, 3,800 patients in intensive care units (ICUs), 40,000 positive in home isolation, and 10,000 deaths, according to the Italian Civil Protection bulletin1. Italy currently has the highest COVID-19 mortality rate worldwide, even compared to the People’s Republic of China where the number of COVID-19 deaths totaled over 3,000 cases, including potential re-infections. Globally, there are ~570,000 cases and 26,000 deaths due to COVID-19. According to the World Health Organization (WHO) as of March 28, 2020, the number of COVID-19 positive cases in Spain is increasing, with 64,000 infected cases and 5,000 deaths.
In the United States, in the span of a few days, there were 85,000 cases and 1,200 deaths due to COVID-19; Germany has 48,000 confirmed cases, and France has 32,000 cases with 600 deaths2.
After a short respite with 9,000 COVID-19 cases and only 140 deaths, the infection has resurged and the number of confirmed cases are continuously increasing in South Korea3. An analysis of the data in the daily updates communicated by the Civil Protection, showed that most of the COVID-19 cases and deaths are limited to Northern Italy—especially Lombardy, Emilia Romagna, Veneto, and Piedmont—with the numbers fortunately decreasing toward central and southern Italy, and very few cases documented in Basilicata1. The most severely affected regions are also the regions where healthcare services have always been considered excellent; the hospitals of Lombardy and Veneto are the Italian centers of excellence with regard to standard protocols and management for many diseases, especially neoplastic conditions, and there was a high rate of passive migration of patients from the South to northern hospitals.
The Lombardy region has a higher number of intensive care and resuscitation beds compared to southern Italy; unfortunately, these places are fast running out of hospital beds and facing challenges in the provision of primary care for conditions other than COVID-19, necessitating the transfer of numerous patients to other regions4. The situation would probably have been considerably worse if the regions of Southern Italy had the highest number of COVID-19 cases.
These numbers confirm the fact that we are facing a pandemic, which was declared by the WHO a few days ago.
Italy is located in south-central Europe, and it is also considered a
part of western Europe.
First we look at the summary of the corona virus cases in Italy
## date province country lat
## Min. :2020-01-22 Length:2652 Length:2652 Min. :41.87
## 1st Qu.:2020-08-29 Class :character Class :character 1st Qu.:41.87
## Median :2021-04-07 Mode :character Mode :character Median :41.87
## Mean :2021-04-07 Mean :41.87
## 3rd Qu.:2021-11-14 3rd Qu.:41.87
## Max. :2022-06-23 Max. :41.87
## long type cases uid
## Min. :12.57 Length:2652 Min. :-4144608 Min. :380
## 1st Qu.:12.57 Class :character 1st Qu.: 42 1st Qu.:380
## Median :12.57 Mode :character Median : 442 Median :380
## Mean :12.57 Mean : 6878 Mean :380
## 3rd Qu.:12.57 3rd Qu.: 6760 3rd Qu.:380
## Max. :12.57 Max. : 228123 Max. :380
## iso2 iso3 code3 combined_key
## Length:2652 Length:2652 Min. :380 Length:2652
## Class :character Class :character 1st Qu.:380 Class :character
## Mode :character Mode :character Median :380 Mode :character
## Mean :380
## 3rd Qu.:380
## Max. :380
## population continent_name continent_code
## Min. :60461828 Length:2652 Length:2652
## 1st Qu.:60461828 Class :character Class :character
## Median :60461828 Mode :character Mode :character
## Mean :60461828
## 3rd Qu.:60461828
## Max. :60461828
| type | minimum | maximum | median | mean | total |
|---|---|---|---|---|---|
| confirmed | 0 | 228123 | 7217.5 | 20443.5667 | 18072113 |
| death | 0 | 993 | 99.0 | 190.0633 | 168016 |
| recovery | 0 | 53074 | 409.5 | 4693.8575 | 4149370 |
| Country | Confirmed | Death | Recovery | Active | Death_Percentage | Recovered_Percentage | Active_Percentage |
|---|---|---|---|---|---|---|---|
| Spain | 18071782 | 167998 | 4145492 | 12438391 | 0.93 | 22.94 | 68.83 |
| Saudi Arabia | 788294 | 9194 | 507374 | 271726 | 1.17 | 64.36 | 34.47 |
| Italy | 12698470 | 109703 | 150376 | 12438391 | 0.86 | 1.18 | 97.95 |
| India | 43362294 | 524955 | 30977006 | 11860333 | 1.21 | 71.44 | 27.35 |
Second, mathematical predictions about the future evolution of the epidemic are subject to a significant level of uncertainty due to several influencing factors, such as people’s individual behaviours and compliance with containment measures that are being implemented , meaning that it will take some time before it is possible to actually evaluate the efficacy of such interventions. Epidemiological investigations suggested that the infection transmission took place within the country for all identified cases, with the exception of the first two ones that were reported by the Lazio region and were probably infected in China . Regarding the regional distribution of cases, by the 19 March, COVID-19 cases had been reported in all Italian regions [14]. Cases were mainly concentrated in the Northern part of the country, especially in the regions of Lombardia (which represents the epicentre of the epidemic), Emilia Romagna, Veneto and Marche [14]; however, according to the infographics published on the 27 March, Piemonte, Toscana and Lazio add to the list of most affected regionn. In some regions, cases are more sporadic, with more limited transmission chains .
Third, the number of deaths in Italy has now surpassed China’s officially reported deaths, but when analysing this type of epidemiological data, the national context should always be taken into account: the Italian population is relatively old and the CFR for COVID-19 is higher for the elderly; also, social distancing is not part of the Italian culture, unlike other cultures where it is implemented in people’s daily routines. Social distance has so far generated serious consequences, affecting social relationships and interactions (especially the empathic process), the economy and employment rates, and widening the digital and cultural infrastructure divide.
Last but not least, the most important question remains on how to manage the epidemic in the long-term in view of the need at some point to restore economic activities. It has been argued that a strong and better economic recovery from the COVID-19 pandemic requires governments to make the services sector a key element in their policy mix, as services play a key role in increasing productivity, efficiency and effectiveness in the whole economy. On 27th October, the Italian Government approved the “Ristori” Decree Law [29], which introduces further urgent measures for the protection of health and for the support of workers and production sectors, as well as in the field of justice and safety related to the COVID epidemic -19. The Decree Law allocated 5.4 billion euros in terms of net debt and 6.2 billion in terms of balance for the restoration of the economic activities concerned, directly or indirectly, by the restrictions placed on health protection by the 24th of October Decree Law. This Decree, valid until today, mandated that public places (bars and restaurants) may remain open every day including weekends and holidays until 6.00 pm; closure of gyms and swimming pools; and suspension of cinema and theatre activities